Choosing a Study Population & Details on Carrying out the Study
Several parts of this study would need to be carefully defined. First, one would need to define the study population, from which the participants would be chosen, and then randomized to the exposed & unexposed groups.
Because men and women are physically built differently, which can lead to different running-related injuries (Chumanov, et al., 2008, link: http://www.engr.wisc.edu/groups/nmbl/pubs/cb08_chumanov.pdf ) an equal number of men and women in the study population sample would help clarify the injury differences (the results could be stratified, or categorized, by age and sex, for clarification of gender and age differences).
Defining the population sample might be challenging, as there are runners of varyingly levels of fitness, agility, and with different habits (stretching-vs-not stretching). In order to try to make the sample a little more homogenous, I might choose healthy, uninjured recreational runners that have been running for 5 to 10 years, for a set range of miles per week, participating in a certain amount of longer distance competitive runs (such as half-marathons & marathons) per year. I also might chose some from different settings, such as different geographic areas (urban U.S., potentially from an East Coast city (such as New York) & from a West Coast city (such as Los Angeles), where there are likely to be larger running clubs, or training organizations, to recruit from.
Because this study could potentially be expensive, the sample sizes would need to be adequate enough to compare results, but not necessarily huge. Depending on my funding, I might choose 500 runners for the exposed group, and 500 runners for the unexposed group, with equal numbers of men and women.
All participants would be required to undergo an initial sports medicine physical, and rule out any past serious injuries or orthopedic surgeries, to qualify for the study. They would then be randomly assigned to the group with traditional shoes (no intervention, or unexposed), or to the “barefoot-type” shoes (exposed, intervention). All participants would be properly fitted for size in either type shoe by professionals.
Potential running-related injuries would need to be defined, such as hip bursitis, iliotibial band syndrome, hip stress fractures, pulled hamstrings, patellofemoral syndrome, plica syndrome, dislocating knee-cap, shin splints, exercise-induced compartment syndrome, ankle sprain, Achilles tendonitis, plantar fasciitis, foot stress fractures, and arch pain (Cluett, 2009, link: http://orthopedics.about.com/cs/sportsmedicine/a/runninginjury.htm).
Each group could be assigned to a sports medicine team (orthopedic physician, physical therapist, trainer, etc.). If injury should occur, the participants would need to go to their team for evaluation, and recording, of the injury, with some sort of standardization of diagnostic criteria. Criteria for dropping out of, or staying in, the study after injury would need to be decided on, as well as treatment protocols.
After the time period of the study/data collection has passed, then the rates of injury could be compared between the traditional shoe group & the barefoot-type shoe group.
The epidemiologists and statisticians analyzing the data should be objective, and without any preconceived ideas regarding the outcome, otherwise, there can be an analytic bias (Gordis, 2009, p 174).
Funding could be solicited from athletic shoe companies and sports medicine, sports training, and physical therapy groups (or at least they could supply the shoes, and the labor for the injury teams!). However, to rule out conflict of interest, the companies or employees of the shoe companies could not be involved in the study itself. For a less biased study, shoes would be independently purchased, to deflect any suspicion of conflict of interest (that is what Consumer Reports does!).
A blind study would be impossible, as the runners in each group would know what kind of shoes they were wearing, as well as that injuries were being monitored.
Compliance & Other Challenges
As regular runners would not want to become injured, I feel that they would definitely report any injuries. However, if they did not like the shoes that they were issued, they might be more likely to drop out of the study, rather than to keep running in shoes they didn’t like! Also, because different shoe brands seem to fit different people, it would be hard to rule out differences in injuries between different brands of traditional shoes, unless one were to use only one brand (which might lead to another compliance issue!). In my purely anecdotal experience, runners can be very picky about their shoes!
References:
Chumanov, E.S., Wall-Scheffler, C., & Heiderscheit, B.C. (2008). Gender differences in walking
and running on level and inclined surfaces. Clinical Biomechanics, 23, 1260–1268.
Retrieved from http://www.engr.wisc.edu/groups/nmbl/pubs/cb08_chumanov.pdf
Cluett, J. (2009). Running Injury: Information about common injuries in runners. About.com Retrieved from http://orthopedics.about.com/cs/sportsmedicine/a/runninginjury.htm
Gordis, L. (2009). Epidemiology, 4th ed. Philadelphia: Saunders Elsevier
that's wonderful subject, I like your idea, I do have problem with chosing the right shoes, because I spent a lot time out and would like shoes that allow me to walk, and sometime have light physical activity, like running. I am interested to see such study conducted in the real world and have result published for different shoes. it might be interesting to include trying those shoes in different ground, and my guess that the best shoe will be the one that can be used accommodate different grounds.
ReplyDeletein general successful idea
I like the idea of trying out the shoes on different surfaces! Could maybe stratify the results of different surfaces & different activities. Thanks for your comment!
ReplyDeleteIt is a very interesting subject. I never think of wearing right shoes would cause fewer injury. I am just wondering how to are going to control the route that sample population would run. Because I think hilly or flat route might impact the outcome.
ReplyDeleteGood thoughts, Christine. Hills or uneven ground could definitely impact ankle sprains & other injuries. When I chose to use well conditioned, long-term runners, my thought was that they would have fewer "new-runner" injuries, and that they would be used to running on whatever surfaces they run on.
ReplyDelete